JKO DoD Opioid Provider Safety Training Program

Carefully monitored opioid taper should be considered in which of the following situations?

All of the above

Self-management strategies for pain are designed to achieve the following goals EXCEPT:

Improvement of a patient's marathon running times

The 2020 revision to DoDI 1010.16 directs that, absent a time period specified by the prescriber, controlled substance prescriptions for Active Duty Service Members expire _______

6 months after the last fill date

Which of the following tools is/are available to help assess for opioid-related risks and the indications for prescribing Naloxone?

All of the above

All patients prescribed opioid therapy are required to be enrolled in the MTF Sole Provider Program?

False

The following are DSM-5 diagnostic criteria of Opioid Use Disorder EXCEPT?

Requesting a refill for initial opioid prescription

According to the DHA-PI Pain Management and Opioid Safety, which of the following are NOT indicators for co-prescribing of Naloxone?

None of the above, all of these groups should be prescribed Naloxone

Which of the following are recommended for disposing of expired or unused prescription medications:

Mail-in envelopes distributed at MTF pharmacies
Designated collection receptacles co-located at MTF pharmacies

Which TWO of the following are part of the DoD comprehensive biopsychosocial pain assessment?

Pain Assessment Screening Tool and Outcomes Registry (PASTOR)
The Defense and Veterans Pain Rating Scale (DVPRS)

The objective(s) of using informed consent when prescribing opioids is to:

II, III, and IV

Which of the following components of Stepped Care Model of pain management is first introduced in Step 3

NOT: Pain severity screening and assessment

The majority of patients with chronic pain are managed in

Primary Care

Pain affects more Americans than diabetes, heart disease, and cancer combined.

True

The DoD strategies and policies for Safe Medication Use, Storage, Disposal, and Take Back were developed to address

I, III, and IV

The most important goal(s) that should guide pain management decisions by patients and their providers include(s) which of the following

II and IV

Essential components of Safe Opioid Prescribing includes which of the following

All of the above

What is the first "step" in the Stepped Care Model of Pain Management?

Self-Care and Patient Education

Which of the following should be considered for the first line of treatment for chronic pain?

NOT III and IV

The first and most important element of good pain care is

NOT Exploring non-pharmacological treatments for pain care NOT: Safe opioid use

The following statement(s) are true regarding the use of routine drug screening as part of safe opioid prescribing

NOT: I and IV; not I and III; not I, II and IV

There are 3 components of pain that providers should consider during their assessment and treatment plans? Which component does not belong

Biologic

When taken as prescribed, long term use of opioids can result in the following adverse medical and psychological outcomes

All of the above

The ultimate goal of the Stepped Care Model of pain management is to

Decrease healthcare reliance by assisting patients in adopting self care management early in the pain cycle? NOT maximize use of available resources across

Which of the following clinician actions is recommended prior to prescribing opioid therapy for treatment of non-cancer, chronic pain?

Verify that non-opioid medications have been considered and optimized prior to prescribing opioids

Which of the following components of Stepped Care Model of pain management is first introduced in Step 3

NOT Consultation between Primary Care and Pain Specialty Care

Which of the following statements regarding the prevalence of pain in Service members and Veterans is false?

NOT: As many as 75% of female Veterans suffer from chronic pain

What is the first "step" in the Stepped Care Model of Pain Management

Self-Care and Patient Education

Which of the following is a true statement regarding the use of opioids in the United States

all of the above

Which of the following components of pain is not incorporated in the biopsychosocial model of pain?

Medical

True or False: Risk Index for Prescription Opioid Overdose and Opioid-induced Serious Respiratory Depression (RIOSORD) is a validated risk stratification tool that defines patient risk classes and predicts probability of a significant adverse event and is helpful when deciding to prescribe Naloxone.

True

There are certain standards that all providers must remember when treating any patient for any condition, even wounded war heroes. Which of the following statements is incorrect?

For confidentiality reasons, do not document care plan in chart

Evidence-based treatments for patients with Opioid Use Disorder (OUD) include:
1. Medication-Assisted Treatment (MAT) with buprenorphine or methadone
2. Recovery support services
3. Behavioral therapies
4. Psychoanalytic therapy

NOT: all of the above

True or False: The US Center for Disease Control (CDC) recently released 12 guidelines for prescribing opioids to reduce opioid related patient harm. One of the recommendations is to use urine drug testing before starting opioid therapy and at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.

True

Which of the following statements is incorrect? Good prescribing practices by health care providers include:

Ignore aberrant behavior such as provider shopping or early refills

When it comes to dosing, CDC Guidelines recommend that you carefully reassess evidence of individual benefits and risks when increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day.

True

For prescribing opioids, treatment agreements with patients should have the following qualities:
1. be readable, reasonable and flexible. They should avoid using absolute terms such as "will" or "shall" and should use "may" in most cases.
2. Identify penalties for misuse or diversion - legal (police report) and medical (forced detox, forced taper, or cessation of medical treatment based on the clinical scenario)
Choose one

Both

Referring a Soldier to the local substance abuse program can be an unpopular move. You'll likely get resistance from the patient and sometimes the chain of command might object to what they feel is unnecessary meddling. Which of the following statements is correct?

2 It's important that you trust your judgment and do the right thing. It could very well be a matter of life and death?

According to CDC Guidelines, which of the following statements is incorrect?

NOT: If opioids are used, they should be combined with non-pharmacologic and non-opioid pharmacologic therapy?

In a series of recent surveys, misusers indicated that only about 1 in 5 obtained their misused medications through a legitimate prescription. The majority obtained them through diversion from a friend or relative.

True